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EVALUATION OF CT AND MR ANGIOGRAPHY IN DETECTION OF INTRACRANIAL ANEURYSMS - A LITERATURE REVIEW
No full textCILJ: Usporediti radiološke dijagnostičke modalitete CTA i MRA u dijagnosticiranju intrakranijalnih aneurizmi . Nadalje, istražiti koja je dijagnostička metoda pouzdanija, sigurnija, kvalitetnija za dijagnosticiranje istih i kada se koriste.
METODE: Pretraživanje znanstvene literature koristeći nekolicinu važnih baza znanja upotrebom izraza kompjuterizirana tomografska angiografija CTA, magnetska razonancijska angiografija MRA i intrakranijalna aneurizma, kroz naslove članaka, sažetke i ključne riječi. Baze podataka koje su pretražene jesu PubMed-Medline, Scopus. Pregledom meta-analizi, početna strategija pretraživanja dala je 376 relevantnih citata. Od njih, 174 članka su korištena za detaljnu procjenu, a 202 su isključena. Konačno, 97 članaka zadovoljilo je stroge kriterije uključivanja.
REZULTATI : U ovoj studiji, AUC indeks korišten je za usporedbu razlike vrijednosti dijagnoze između CTA i MRA za intrakranijsku aneurizmu. Utvrdili smo da ne postoji značajna razlika između dvije metode (Z = 0.828, P> .05). Osjetljivost i specifičnost MRA za identifikaciju intrakranijalne aneurizme veličine preko 3 mm je 87 do 100% odnosno 86 do 100%, a osjetljivost i specifičnost CTA za dijagnosticiranje intrakranijalne aneurizme je 92,8 do 100%, odnosno 83 do 100%.
ZAKLJUČAK: Obje slikovne metode imaju vrlo visoku i praktički jednaku dijagnostičku preciznost ( MRA osjetljivost i specifičnost 87-100 %, odnosno 86 - 100 %, CTA osjetljivost i specifičnost 92,8 do 100 %, odnosno 83 do 100 %) u otkrivanju i karakteriziranju intrakranijalnih aneurizmi. Radiološki tehnolog mora vladati znanjima o prednostima i nedostacima ove dvije metode, uz to mora biti kompetentan u izvođenju istih te pratiti najnovije standarde temeljene na znanstvenim istraživanjima u protokolima za dobivanje kvalitetnih dijagnostičkih informacija te primjenjivati iste u dogovoru s radiolozima.OBJECTIVE: Comparison of radiological diagnostic modalities CTA and MRA in the diagnosis of intracranial aneurysms as dilatations of cerebral arteries caused by hemodynamic factors and changes occurring in the arterial wall. Furthermore, to find out which diagnostic method is more reliable, safer, of better quality for diagnosing them and when they are used. METHODS: Comprehensive literature search using several large databases using the terms “computer tomography angiography” (CTA) and “magnetic resonance angiography” (MRA) and “intracranial aneurysm∗” in the article titles, abstracts, and keywords. The databases searched are PubMed-Medline, Scopus. In this meta-analysis, the initial search strategy yielded 376 relevant citations. Of these, 174 articles were retrieved for detailed evaluation and 202 were excluded. Finally, 97 articles met the rigid inclusion criteria.
RESULTS: In this study, the AUC index was used to compare the difference of diagnosis value between CTA and MRA for intracranial aneurysm. We found there was no significant difference between the two methods (Z = 0.828, P> .05). The sensitivity and specificity of MRA for the identification of intracranial aneurysms over 3 mm in size is 87 to 100% and 86 to 100%, respectively, and the sensitivity and specificity of CTA for diagnosing intracranial aneurysms is 92.8 to 100% and 83 to 100%, respectively.
CONCLUSION: Both imaging methods have very high and practically equal diagnostic accuracy in the detection and characterization of intracranial aneurysms (sensitivity and specificity of MRA for the identification of intracranial aneurysms over 3 mm in size is 87 to 100% and 86 to 100%, respectively, and the sensitivity and specificity of CTA for diagnosing intracranial aneurysms is 92.8 to 100% and 83 to 100%). The radiological technologist must have knowledge of the advantages and disadvantages of these two methods, in addition he must be competent in performing them and follow the latest standards based on scientific research in protocols for obtaining quality diagnostic information and apply them in agreement with radiologists
USE OF DENTAL RADIOGRAPHY IN FORENSIC
No full textRadiološke metode u forenzičkoj radiologiji koriste se u procjeni dobi, kod utvrđivanja uzroka smrti, te kod identifikacije. Forenzička stomatologija kao grana forenzike predstavlja preklapanje stomatološke i pravne struke, bitne u identifikaciji žrtve, te procjeni dentalne dobi. Forenzička radiologija daje odgovore u radiološkim postupcima i pregledima Postoji tehnika zubnog profiliranja kojom se ispituju zubi i zubno tkivo. Važan dio stomatološke prakse predstavljaju radiogrami za potvrdu dijagnoze, kao i već navedeno u procjeni dentalne dobi i u identifikaciji. Radiogrami se dijele na intraoralne i ekstraoralne. Naglasak je na ortopantomogramu koji daje sliku kompletne gornje i donje čeljusti. Zubi su čvrsti, mineralizirani organi, koje izgrađuju mekana i tvrda zubna tkiva. Jedne su od najjačih struktura u tijelu, te se ne razaraju lako kao ostale tjelesne strukture. To im daje veliki značaj u procesu identifikacije. Stomatološka identifikacija uključuje metode podudaranja, postmortem profiliranje, genetski otisak prsta, procjenu zubnog profila, te biometriju zuba s digitalnim oduzimanjem. U procesu stomatološke identifikacije koristi se denticija. Služi za komparaciju AM (antemortem) i PM (postmortem) postupka, za određivanje rase, spola i starosti u trenutku smrti, te izolaciju DNA iz zubnog tkiva. Antemortem postupak obuhvaća pisane podatke, rendgenske snimke, otisak zuba, osobnu fotografiju, podatke od strane obitelji. Postomortem postupak će pružiti informacije o dobi žrtve, porijeklu predaka, spolu i socio-ekonomskom statusu. Određivanje dentalne dobi podijeljeno je u dvije velike skupine, određivanje dobi kod djece i adolescenata, te kod odraslih. Najpreciznije su metode kod određivanja dobi kod djece jer su svi zubi u razvoju, a analiza se temelji na analizi rasta i razvoja. U odraslih procjena dobi se temelji na istrošenosti zubnih površina, stoga je to postupak s manjom točnosti. Najpoznatije rendgenske tehnike za procjenu dobi kod djece su: Demirjian, Haavikko, Moorreess i Cameriere tehnike. Dentalnu dob kod odraslih istraživali su mnogobrojni stručnjaci, a najpoznatije su metode po Gustafsonu, Johansonu, Camerieru i Lovejoy-u. Prema dostupnim podacima prve metode su se počele koristilo još davne 1800. godine. Metoda prema Gustafsonu 1950. godine bila je glavna okosnica i smjernica svim ostalim znanstvenicima za daljni razvoj metoda za određivanje dentalne dobi.Radiological methods in forensic radiology are used in age estimation, in determination of death and identification. Forensic stomatology as a part of forensic represents overlap dental and legal profession, important in identification of victim and the age estimation. Forensic radiology gives the answers in radiological procedurs and examination. There is a technique of dental profiling which examines tooth and tooth tissue. Important part of dental practice are radiograms for conformation the diagnosis, as alredy is stated in age estimation and in identification. Radiograms can be intraoral and extraoral. The most important is orthopantomogram which gives us an image of the complete upper and lawer jaw. Theets are solid, mineralized organs, which are builed of soft and hard dental tissue. These are one of strongest structure in body and they can not be devastated as esay as other body structure. This gives them great significant in the proces of identification. Dental identification includes matching methods, postmortem profiling, genetic fingerprint, estimate of dental profile and tooth biometric with digital extraction. In proces of dental identification is used dentition. It is used for comparation AM (antemortem) and PM (postmortem) procedure, determining race, gender, age at the time of death and isolation of DNA from teeth tissue. Antemortem procedure involves written data, radiograms, tooth impression, personal photo and datas by family. Postmortem procedure gives us information about the age of victim, fathers origin, gender and socio-economic status. Dental age estimation is splitted in two large groups, dental age estimation of children and adolescent, and in adults. The most precise methods in age estimation of childrens because all teeths are developing, and the analysis is based on analysis of growth and rase. In adults age estimation is based on the wear of tooth surfaces, and that is the reason why this method is with less accuracy. The most famous radiological techniques in childrens age estimation are: Demirjian, Haaviko, Moorrees and Cameriere methods. Dental age in adults has been studied by many experts, and the most famous are Gustafson, Johanson, Cameriere and Lovejoy methods. According to available date first methods were used in 1800. Gustafson method 1950. was the mane framework and guidelines to the others scientist for further development of methods for dental age estimation
DIAGNOSTIC OF GONORRHEA IN PREGNANT WOMEN AND NEWBORNS- MIDWIFE ACTIVITY
No full textFiziološka flora čovjeka je vrlo složena. Čovjeku su potrebni mikroorganizmi na koži i sluznicama da bi bio zdrav. Ti mikroorganizmi s ljudskim domaćinom imaju mutualistički odnos. Odnosno i jedni i drugi imaju koristi. Mikroorganizmi neprestano dobivaju nutrijente potrebne za život dok čovječja flora dobiva zaštitu i nutrijente. Ukoliko dođe do narušavanja imuniteta ili kontakta sa patogenim mikroorganizmima normalna flora se narušava te dolazi do infekcije. Ukoliko se infekcija razvije nakon spolnog odnosa sa zaraženom osobom tada je riječ o spolno prenosivim bolestima.
Spolno prenosive bolesti su u populaciji oduvijek prisutne i biti će prisutne i u budućnosti s obzirom na širenje spolnim kontaktom. Ulazna vrata mikroorganizama spolno prenosivih bolesti su sluznice, najčešće sluznice spolnih organa.
Gonoreja je spolno prenosiva bolest koja u većini slučajeva prolazi asimptomatski, a ukoliko se pojave simptomi to su gnojni iscjedak iz rodnice, bol u donjem djelu abdomena, bol prilikom odnosa, krvarenje nakon odnosa, spotting, neplodnost,...
N. gonorrhoeae su gram negativni diplokoki koji ne stvaraju spore i teško preživljavaju u okolišu što znači da je za prijenos potreban direktni put. Bakterija je primarno patogena za čovjeka jer nije dio fiziološke flore. Prenosi se spolnim odnosom ili s majke na dijete prolaskom kroz zaraženi porođajni kanal.
Gonoreja se dijagnosticira iz brisa cerviksa koji se nasijava na čokoladni agar te nakon 48 sati izrastu prozirne sitne kolonije nalik kapima rose. Na predmetnom stakalcu, mikroskopskom preparatu bojanom po gramu uočavamo gram negativne diplokoke unutar leukocita koji nalikuju zrnu kave.
Za liječenje se prvo izrađuje antibiogram da bi se odredio antibiotik najbolje učinkovitosti. Potrebno je liječiti oba partnera jer ako se ne liječe oba partnera istovremeno dolazi do ponovne aktivacije bolesti.Primalja ima veliku važnost u prevenciji, dijagnostici i liječenju gonoreje. Primalja prvenstveno treba žene prosvjećivati i uputiti na važnost redovitih ginekoloških pregleda. Također primalja je i potpora ženama koje imaju gonoreju te im treba pružati empatiju jer su kod nas spolno prenosive bolest još uvijek tabu tema i žene zbog srama nekada ne žele otići na pregled iako imaju simptome spolno prenosivih bolesti. Primalja upućuje na pravilan način uzimanja lijekova za liječenje bolesti, ali i sudjeluje u prevenciji prijenosa bolesti s majke na dijete tako što nakon rođenja djeteta provodi Credeovu profilaksu srebrovom otopinom koja se kapa novorođenčetu u oči.Human physiological flora is very complex. Human needs microorganisms on his skin and mucous membranes to be healthy. These microorganisms have a relationship with the human host. That is, both benefit. Microorganisms are constantly getting the nutrients they need to live while the human flora is getting protection and nutrients. If you get a violation of immunity or contact with pathogenic microorganisms, the normal flora is disturbed and an infection occurs. If the infection develops after sexual intercourse with earned persons, then it is a sexually transmitted disease.
Sexually transmitted diseases have always been present in the population and will be present in the future with wider sexual contact, which is the most common and natural human contact. The entrance door of the microorganism sexually transmits diseases in the mucosa, and the smallest mucosa of the genitals.
Gonorrhea is a sexually transmitted disease that usualy passes asymptomatically, and symptoms appear to be purulent discharge from the vagina, pain in the abdomen, better situation, bleeding after intercourse, spotting, infertility,...
N. gonorrhoeae are gram-negative diplococci that do not produce spores and are difficult to survive in the environment which means they should transmit the necessary direct, capillary pathway. The bacterium is a primary pathogen for humans because it is not part of the physiological flora. Sexual intercourse is transmitted either from mother to child by passing through an infected birth canal.
Gonorrhea is diagnosed from a swab of the cervix that is seeded on chocolate agar and after 48 hours expresses transparent tiny colonies resembling rose drops. On the slide, a gram-stained microscopic specimen, we observe a gram of negative diplococci inside leukocytes resembling coffee beans.
For treatment, an antibiogram is first made to determine which antibiotic is best. A doctor with both partners is needed if there is no re-execution of the partner and he will re-activate the disease.
Midwives has great importance in the treatment, diagnosis and prevention of gonorrhea. The midwife can primarily protest the women and teach them on the importance of regular gynecological examinations. Also a midwife is the support of women who have gonorrhea and they need to be given empathy because in our country sexually transmitted diseases are still a taboo topic and women sometimes do not want to go for checkup out of shame even though they have symptoms of sexually transmitted diseases. The midwife was instructed in the proper way of taking medication to treat the disease, but also participated in the prevention of disease transmission from mother to child in order to carry out Crede's prophylaxis with a silver solution after the birth of a child
THE EDUCATIONAL IMPORTANCE OF THE NURSE IN THE ELDERLY
No full textU cijelom svijetu dolazi do povećanja broja starijih osoba zahvaljujući napretku medicine. Do 2050. godine očekuje povećanje broja stanovnika starijih od 60 godina i više za 900 milijuna u odnosu na 2015. godinu. Najveći udio starijeg stanovništva u EU imaju: Malta, Finska, Češka i Nizozemska. Zbog stalnog porasta starijih ljudi, neophodno je pružanje kvalitetne zdravstvene skrbi i zaštite jer ova skupina korisnika imaju veću zdravstvenu potrebu.
Djelatnost medicinske sestre u zdravstvenoj njezi starijih osoba iziskuje poseban pristup u zadovoljavanju potreba i u rješavanju problema treće dobi. Jedna od najvažnijih uloga medicinskih sestara danas je obrazovanje bolesnika. Kvalificirane medicinske sestre od posebne su važnosti za zdravstvene sustave u cijelom svijetu, a medicinske sestre edukatori su pokretačka snaga obuke kvalificiranih medicinskih sestara.
Medicinske sestre edukatori podučavaju druge medicinske sestre, pomažu u planiranju zdravstvene skrbi, podučavaju bolesnike i dr. Sestre imaju važnu ulogu u prevenciji i upravljanju bolestima jer su obično prva i najkonzistentnija točka kontakta te u najpovoljnijoj poziciji za prikupljanje informacija o bolesniku, obitelji, dosadašnjem načinu života te o socijalnim, kulturalnim i ekonomskim čimbenicima važnim za planiranje daljnje skrbi.
Edukacija oboljelog mora biti sveobuhvatna i lako razumljiva jer procesom starenja opada brzina intelektualnog rada, ali ne i sposobnost, što znači da osobe starije dobi mogu djelotvorno učiti, ali im je za to potrebno više vremena. Neke od učinkovitih metoda podučavanja su intervju, savjetovanje, davanje uputa i demonstracija. U svim metodama podučavanja važno je dati mogućnost korisniku usluge za razgovor kako bismo mu omogućili iznošenje vlastitog mišljenje te viđenje problema.
Važno je istaknuti kako bolesnici moraju preuzeti proaktivnu ulogu u vlastitoj zdravstvenoj skrbi, odnosno trebaju razumjeti svoje zdravstveno stanje i raditi na stabilizaciji, sprečavanju ili minimiziranju komplikacija kroničnih bolesti.There is an increase in the number of older people all over the world thanks to advances in medicine. By 2050, it expects an increase in the number of residents over the age of 60 and more by 900 million compared to 2015. Malta, Finland, the Czech Republic and the Netherlands have the largest share of the elderly population in the EU. Due to the constant growth of older people, it is necessary to provide quality health care and protection because this group of users have a greater health need.
The activity of a nurse in the health care of the elderly requires a special approach in meeting the needs and in solving the problems of the elderly. One of the most important roles of nurses today is patient education. Qualified nurses are of particular importance to health systems around the world, and educator nurses are the driving force behind the training of qualified nurses.
Nurse educators teach other nurses, help plan health care, teach patients, and more. Nurses play an important role in disease prevention and management because they are usually the first and most consistent point of contact and in the most post-war position to gather information about the patient, family, lifestyle and social, cultural and economic factors important for further care planning.
The education of the patient must be comprehensive and easy to understand because the aging process decreases the speed of intellectual work, but not ability, which means that older people can learn effectively, but they need more time. Some of the effective teaching methods are interviewing, counseling, giving instructions and demonstrations. In all teaching methods, it is important to give the user the opportunity to talk in order to enable him to express his own opinion and see the problem.
It is important to emphasize that patients must take a proactive role in their own health care, ie they should understand their health condition and work on stabilizing, preventing or minimizing the complications of chronic diseases
THE INITIAL NUTRITIONAL STATUS OF IN-PATIENTS TREATED WITH CHEMOTHERAPY AT THE CLINIC OF ONCOLOGY AND RADIOTHERAPY
No full textCilj: Istražiti i definirati početni nutritivni status bolesnika koji se počinju liječiti kemoterapijom u bolničkim uvjetima u Klinici za onkologiju i radioterapiju.
Metode: Za inicijalnu procjenu nutritivnog statusa koristili smo validirani instrument za procjenu nutritivnog rizika razvijen 2002. godine, u originalu na engleskom jeziku Nutritional Risk Screening 2002 (NRS 2002, Prilog 1). Ovu jednostavnu metodu sastavljenu od dvije cjeline preporučuje Europsko društvo za kliničku prehranu (ESPEN; 20).
Rezultati: Od ukupnog broja ispitanika (89), u našem istraživanju, njih 59 (66%) je u posljednja 3 mjeseca izgubilo ≥5% svoje težine dok 30 (34%) ispitanika nije gubilo na težini ili su izgubili <5% svoje težine u posljednja 3 mjeseca. Od 30 ispitanika koji nisu gubili na težini u zadnja 3 mjeseca ili je taj gubitak bio manji od 5%, 19 ispitanika je bilo s prekomjernom težinom, 9 ispitanika je imalo normalnu težinu dok je 2 ispitanika bilo već pothranjeno. Iz rezultata našeg istraživanja razvidno je da je svaki naš ispitanik u blagom do teškom riziku od pothranjenosti. Bez obzira na mali broj ispitanika u našem istraživanju, potvrdili smo ono što smo i pretpostavljali prije početka istraživanja, da je vrijednost ITM, u početnom nutritivnom statusu statistički značajno manja kod pacijenta s dijagnosticiranim karcinomom gušterače u odnosu na pacijente s dijagnosticiranim karcinomom kolona. Ugrožen i loš nutritivni status nerijetko je očekivani dio tijeka zloćudne bolesti, njezina liječenja i kasnijeg oporavka, međutim, našim istraživanjem dokazali smo da je velik broj naših ispitanika, bez obzira na gubitak težine i blagi rizik za pothranjenost, i dalje pretilo.
Zaključci: Procjena nutritivnog statusa bolesnika od je velike važnosti kako u liječenju tako i u ishodu liječenja onkološkog bolesnika, najčešće započinje pri prvom posjetu onkologu, a proteže se tijekom cijelog liječenja, pa čak i kad specifično onkološko liječenje bude završeno. Stoga bi bilo poželjno da u procjeni nutritivnog statusa ne sudjeluje samo liječnik, nego i posebno educirana medicinska sestra, nutricionist/dijetetičar i psiholog. Kao što je poželjno uključiti i podučiti i samog bolesnika da sudjeluje i vodi brigu o svojem nutritivnom statusu, sve u cilju poboljšanja nutritivnog statusa onkoloških pacijenata što može pridonijeti boljem ishodu onkološkog liječenja.Aim: To investigate and define the initial nutritional status of patients beginning chemotherapy treatment in hospital settings at the Oncology and Radiotherapy Clinic.
Methods: For the initial nutritional status assessment, we used a validated nutritional risk assessment tool developed in 2002, originally in English language Nutritional Risk Screening 2002 (NRS 2002, Schedule 1). This simple two-part method is recommended by the European Society for Clinical Nutrition (ESPEN; 20).
Results: Of the total number of subjects (89), in our study, 59 (66%) lost ≥5% of their weight in the last 3 months, while 30 (34%) did not lose weight or lost <5% of their weight in the last 3 months. Of the 30 subjects who had not lost weight in the last 3 months or had this loss less than 5%, 19 were overweight, 9 were normal and 2 were already malnourished. The results of our study show that each of our respondents is at a mild to severe risk of malnutrition. Regardless of the small number of subjects in our study, we confirmed what we assumed before starting the study that the value of BMI, at baseline nutritional status, was statistically significantly lower in patients with pancreatic cancer compared to patients with diagnosed colon cancer. Endangered and poor nutritional status is often an expected part of the course of malignancy, its treatment and subsequent recovery, however, our research has shown that a large number of our subjects, despite weight loss and a slight risk of malnutrition, remain obese.
Conclusions: The assessment of the nutritional status of the patient is of great importance both in the treatment and in the outcome of treatment of the oncological patient, more often beginning at the first visit to the oncologist and extending throughout the treatment, even after specific oncological treatment is completed. Therefore, it would be desirable that not only the physician but also the specially educated nurse, nutritionist / dietician and psychologist participate in the assessment of nutritional status. As it is desirable to involve and teach the patient himself to participate and take care of his nutritional status with goal to improve the nutritional status of oncology patients which contributes to a better outcome of the oncological treatment
Quality control in digital subtraction angiography
No full textNakon predstavljanja prototipa uređaja za digitalnu substrakcijsku angiografiju 1980. godine, ova radiološka metoda se počela sve više primjenjivati u kliničkoj praksi. DSA se danas koristi kao zlatni standard za prikaz krvnih žila korištenjem jodnog kontrastnog sredstva. Uređaj za DSA je kompleksan, a glavni dijelovi su rendgenska cijev, generator i detektori. Upravo zbog kompleksnosti uređaja potrebno je redovito provoditi kontrolu kvalitete kako bi uređaj bio standardiziran odnosno kako bi kvaliteta pretrage bila jednaka u svim dijelovima države. Kontrola kvalitete obuhvaća promatranje, ocjenjivanje te održavanje postupaka pretrage na optimalnim nivoima. Kontrolu kvalitete izvodi radiološki tehnolog, medicinski fizičar, serviseri i inspekcije, a vrši se mjesečno i godišnje. Za kontrolu kvalitete fizičari koriste razne fantome. Neki od parametara koji se pregledavaju na DSA uređajima su: debljina poluapsorpije, veličina polja snimanja, razlučivost visokog i niskog kontrasta te razni dozni parametri.After the introduction of a prototype device for digital subtraction angiography in 1980., this radiological method began to be increasingly applied in clinical practice. Today, DSA is used as the gold standard for displaying blood vessels using an iodine contrast agent. The device for DSA is complex, and the main parts are an x-ray tube, a generator and detectors. Precisely because of the complexity of the device, it is necessary to regularly perform quality control in order for the device to be standardized, which means that the quality of the examination needs to be the same in all parts of the world. Quality control includes observation, evaluation and maintenance of search procedures at optimal levels. Quality control is performed by a radiological technologist, medical physicist, service technicians and inspections. Also, quality control is performed monthly and annually. Physicists use various phantoms quality control. Some of the controlled parameters on DSA devices are half-absorption thickness, radiation field size, high and low contrast resolution and various dose parameters
COMPARISON OF PREVENTION OF DIABETES MELLITUS IN THE RH AND THE EU IN THE PERIOD FROM 2010-2018 AND THE NURSE'S CONTRIBURION IN PREVENTION
No full textCilj: Usporedba prevalencije diabetesa mellitusa u RH i EU u periodu od 2010 do 2018 i doprinos medicinske sestre u prevenciji.
Metode: Prilikom izrade ovog rada korišteni su statistički podatci objavljeni na stranicama Međunarodne federacije za dijabetes (IDF) i Svjetske zdravstvene organizacije (WHO).
Rezultati: Broj oboljelih od dijabetesa u populaciji od 20-79 godina s godinama se povećava, a najveći broj oboljelih ima Njemačka s prevalencijom od 15%. Najmanji broj oboljelih imaju zemlje Sjeverne Europe poput Litve, Latvije i Estonije. Republika Hrvatska s prevalencijom od 6,8% nalazi se na samom dnu liste sa oboljelima od šećerne bolesti u 2019. godini te očekuje daljnji pad broja oboljelih u budućnosti.
Zaključak: Prevencija šećerne bolesti i sprječavanje nastanka njezinih komplikacija od velikog je značaja u borbi s ovom bolesti. U tom procesu nezaobilaznu ulogu ima i medicinska sestra kao članica multidisciplinarnog tima.Objective: Comparison of the prevalence of diabetes mellitus in the RH and the EU in the period from 2010 to 2018 and the contribution of the nurse in it's prevention.
Methods: Data from the International Diabetes Federation (IDF) and the World Health Organization (WHO) are used for the purpose of making this assignment.
Results: The number of diabetics in the population aged 20-79 increases with age, and the largest number of patients is in Germany with a prevalence of 15%. The countries of Northern Europe, such as Lithuania, Latvia and Estonia, have the lowest number of patients. The Republic of Croatia with a prevalence of 6.8% is at the very bottom of the list of diabetics in 2019 and expects a further decline in the number of patients in the future.
Conclusion: Prevention of diabetes and prevention of its complications is of great importance in the fight against this disease. The nurse, as a member of the multidisciplinary team, also has an unavoidable role in this process
SIGNIFICANCE AND IMPORTANCE OF NURSING WORK IN THE CORRECT APPLICATION OF THE MEDICINAL PRODUCTS OF THE OLDER AGE
No full textStarenje je progresivan, postupan i stalan proces u kojemu dolazi do smanjenja strukture i funkcije organa i organskih sustava. Starenjem populacije imamo sve veći udio kroničnih bolesti i to je razlog propisivanja sve većeg broja lijekova. Zbrinjavanje i zdravstvena skrb kroničnog bolesnika su složeni procesi koji u većini slučajeva zahtijevaju korištenje većeg broja lijekova istovremeno. Sve to nažalost dovodi do razvoja neželjenih nuspojava te samog porasta hospitalizacije i mortaliteta kod osoba starije životne dobi. Napretkom u medicini, otkrićem mnogih novih lijekova, primjenom različitih novijih načina liječenja, poput novijih dijagnostičkih pretraga i terapijskih mogućnosti omogućeno je ranije prepoznavanje bolesti i naprednije liječenje kroničnih bolesti. Ali uvijek treba obratiti pozornost na interakciju lijekova, do koje dolazi istodobnim korištenjem više lijekova te je od velike važnosti držati se osnovnog pravila : prilikom primjene 2 lijeka istodobno, uvijek treba primijeniti lijekove poznatih interakcija i nuspojava, a doze prilagoditi toj kombinaciji. Veliku ulogu u samoj pravilnoj primjeni lijekova, prepoznavanju mogućih nuspojava ima medicinska sestra, koja vremenski boravi najduže uz bolesnika te uz pomoć komunikacije, pacijentovog ponašanja te vlastitog znanja i iskustva uviđa potencijalne ili aktivne sestrinske dijagnoze, sposobna je pravovremeno reagirati te zabilježiti sve navedene postupke i promjene u sestrinsku dokumentaciju koja je ključ sestrinskog posla i omogućuje nam da uvidimo i evidentiramo promjene od samog početka hospitalizacije bolesnika. Veoma je bitno pratiti bolesnikovo zdravstveno stanje i nakon otpusta iz bolnice, dati mu odgovarajuće upute, kao i članovima njegove obitelji, ukoliko se radi o bolesniku koji se ne može samostalno brinuti o sebi, te o svim novonastalim promjenama obavještavati liječnika.Aging is a progressive, gradual and constant in which there is a reduction in the structure and function of organs and organ systems. As the population ages, there will always be an increasing proportion of chronic diseases. This is the main reason for prescribing an increasing number of drugs. Chronic patient care and healthcare are complex processes which in most cases require the use of multiple medications at the same time. Unfortunately, that leads to the development of unwanted side as well as an increase in hospitalization and mortality in the elderly. Advances in medicine like discovering new drugs and the application of various new treatments, such as new diagnostic tests and therapeutic options, have enabled earlier recognition of disease and more advanced treatment for chronic diseases. But we should always pay attention to drug interactions, which can occur when we simultaneously use multiple drugs on patients, and it is important to adhere to the basic rule: when administering two drugs at the same time, drugs of known interactions and side effects should always be used and doses adjusted to this combination. A big role in the proper use of drugs and recognizing possible side effects is played by the nurse. She spends the longest time with the patient and with the help of communication with patients, patient behaviour and personal knowledge are very important in active nursing diagnoses, if she is able to respond in a timely manner and record all procedures. Changes in nursing documentation is the key to nursing work and allows us to see the changes from the very beginning of patient hospitalization. It is very important to monitor the patient's health condition and after discharge from the hospital, give him appropriate instructions, as well as his family members in case of a patient who can’t independently take care of themselves, and inform the doctor about any new changes
DYNAMIC NEUROMUSCULAR STABILIZATION IN REHABILITATION OF PATIENTS WITH LOW BACK PAIN
No full textLumbalni bolni sindrom klinički je entitet koji se definira kao bol, mišića napetost i nelagoda koja se može osjetiti u području leđa, između donjeg rebrenog luka i donje glutealne brazde, sa ili bez širenja boli u nogu. Predstavlja veliki javnozdravstveni problem, ali i izazov u liječenju. Najčešća, nespecifična križobolja predstavlja bol u lumbalnoj regiji koja nije objašnjiva sa poznatom specifičnom patologijom.
Rehabilitacija i primjena različitih modaliteta fizikalne terapije sastavni je dio liječenja bolesnika s lumbalnim bolnim sindromom. Provodi se sa ciljem smanjenja boli i mišićne napetosti, povećanja mobilnosti kralježnice, poboljšanja funkcionalnog statusa i kvalitete života. Na ishod liječenja značajno utječe edukacija bolesnika. Bitno je da bolesnik zna glavne uzroke križobolje, pravilno izvođenje aktivnosti svakodnevnoga života i programe terapijskih vježbi te važnost prilagodbe radnog mjesta i životnog prostora.
Dinamička neuromuskularna stabilizacija je funkcionalno- rehabilitacijska metoda duboke stabilizacije lokomotornog sustava, koja se temelji na razvojnoj kineziologiji djeteta u prvoj godini života, na načelima neurofiziologije i biomehanike. Današnjim sjedilačkim načinom života čovjek gubi zdrave obrasce pokretanja, te ih mijenja nefiziološkima koji uzrokuju bol.
Zahvaljujući dokazanoj učinkovitosti u prevenciji i rehabilitaciji lumbalnog bolnog sindroma DNS se sve više uvodi u rehabilitacijske programe.
Cilj rada bio je prikazati učinkovitost dinamičke neromuskularne stabilizacije u rehabilitaciji pacijenata s lumbalnim bolnim sindromom.
Provedena DNS terapija i edukacija pacijenta rezultirala je poboljšanjem funkcionalnog statusa i smanjenjem boli. Bitna stvar koju treba osvijestiti kod pacijenta je potreba redovitog vježbanje i održavanja aktivnosti kako bi se smanjila bol i poboljšala kvaliteta života.Lumbar pain syndrome is a clinical entity defined as pain, muscle tension and discomfort that can be felt in the back area, between the lower rib arch and the lower gluteal sulcus, with or without the spread of pain in the leg. It is a major public health problem, but also a challenge in treatment. The most common, nonspecific low back pain is pain in the lumbar region that cannot be explained by a known specific pathology.
Rehabilitation and application of various modalities of physical therapy is an integral part of the treatment of patients with lumbar pain syndrome. It is performed with the aim of reducing pain and muscle tension, increasing the mobility of the spine, improving functional status and quality of life. The outcome of treatment is significantly influenced by patient education. It is important that the patient knows the main causes of low back pain, the proper performance of daily life activities and therapeutic exercise programs, and the importance of adjusting the workplace and living space.
Dynamic neuromuscular stabilization is a functional-rehabilitation method of deep stabilization of the locomotor system, which is based on the developmental kinesiology of the child in the first year of life, on the principles of neurophysiology and biomechanics. With today's sedentary lifestyle, a person loses healthy patterns of movement, and changes them to non-physiological ones that cause pain.
Thanks to the proven effectiveness in the prevention and rehabilitation of lumbar pain syndrome, DNS is increasingly being introduced into rehabilitation programs.
The aim of this study was to demonstrate the effectiveness of dynamic non-muscular stabilization in the rehabilitation of patients with lumbar pain syndrome. Conducted DNS therapy and patient education resulted in improved functional status and reduced pain. An important thing to make the patient aware of is the need for regular exercise and maintenance of activities to reduce pain and improve quality of life
THE IMPORTANCE OF THENURSING CARE TOWARDS PREVENTION OF INFECTIONS IN PATIENTS WITH URINARY CATHETER
No full textInfekcija je biološki proces pri kojem dolazi do opće ili lokalne reakcije prilikom ulaska štetnih mikroorganizama i njihovog razmnožavanja u tijelu domaćina Urinarne infekcije povezane sa urinarnim kateterom su najčešće bolničke infekcije te predstavljaju ozbiljan javnozdravstveni problem od kojih godišnje oboli oko 150 milijuna ljudi. Prema studijama prevalencije kateterizirano je 17,5% bolesnika u Europi i 23,6% bolesnika u Sjedinjenim Američkim državama. Jednokratna kateterizacija uzrokuje infekciju urinarnog trakta u samo 1% bolesnika, dok se unutar pet dana od postavljanja urinarnog katetera bakteriurija javlja u 10 - 27% hospitaliziranih osoba.
Medicinske sestre imaju osobitu važnost u prevenciji urinarnih infekcija kod bolesnika sa urinarnim kateterom jer mnoge preventivne intervencije spadaju u njihov djelokrug rada. Sam postupak urinarne kateterizacije se mora provoditi aseptičnom tehnikom koja se treba koristiti tijekom cijelog postupka, a sav pribor mora biti sterilan te jednokratan. Za uvođenje urinarnog katetera medicinska sestra treba pripremiti bolesnika, pribor, prostoriju i sebe. Važno je redovito provođenje higijene ruku osoblja, a sve u svrhu prevencije infekcije.
Nakon što se izabere adekvatna veličina katetera i materijal, medicinska sestra treba brinuti o svakodnevnom nadzoru nad urinarnim kateterom, drenažnim sustavom, toaletom meatusa te skrbiti o bolesniku. Urinarni kateter je potrebno postaviti preko natkoljenice osobe, kako ne bih došlo do pritiska cijevi i spriječio protok mokraće kroz cijev. Uzorke urina za dijagnostičke pretrage kod uvedenog katetera potrebno je uzimati aseptičnom tehnikom. Cilj svakodnevnog nadziranja je da se dnevno revidira potreba za urinarnim kateterom. Ako urinarni kateter više nije potreban, treba ga odstraniti.
Najčešći problemi koji se pojavljuju kod bolesnika koji imaju urinarni kateter su visok rizik za infekciju te smanjena mogućnost brige o sebi – eliminacija. Danas postupak prevencije, koji je, osim što obuhvaća potreban pribor za kateterizaciju i rukovanje, proširen i na cjelovit bolesniku usmjeren pristup. Od iznimne je važnosti provođenje edukacije osoblja, a osobito novozaposlenog kadra te podučavanje pacijenta i njegove obitelji.Infection is a biological process that occurs when pathogenic microorganisms enter and multiply in the host's body, causing a local or general reaction. Urinary catheter-related urinary tract infections are the most common nosocomial infections and represent a serious public health problem that affects approximately 150 million people annually. According to prevalence studies, 17.5% of patients in Europe and 23.6% of patients in the United States were catheterized. One-time catheterization causes urinary tract infection in only 1% of patients, while within five days of placement of the urinary catheter bacteriuria occurs in 10 - 27% of hospitalized persons.
Nurses are of particular importance in the prevention of urinary tract infections in patients with a urinary catheter because many preventive interventions fall within their remit. The urinary catheterization procedure itself must be performed by an aseptic technique, which should be used throughout the procedure, and all accessories must be sterile and disposable. For the introduction of a urinary catheter, the nurse should prepare the patient, accessories, room, and herself. It is important to carry out regular hand hygiene of the staff, all for infection prevention.
Once the appropriate catheter size and material has been selected, the nurse should take care of the daily monitoring of the urinary catheter, drainage system, meat toilet, and care for the patient. A urinary catheter should be placed over a person’s thigh, so as not to put pressure on the tube and prevent the flow of urine through the tube. Urine samples for diagnostic tests with the introduced catheter should be taken by an aseptic technique. The goal of daily monitoring is to review the need for a urinary catheter daily. If a urinary catheter is no longer needed, it should be removed.
The most common problems that occur in patients who have a urinary catheter are a high risk of infection and a reduced ability to take care of themselves - elimination. Today, the prevention procedure, which, in addition to encompassing the necessary catheterization and handling equipment, is an extended and patient-centered approach. It is extremely important to educate the staff, especially the newly employed staff, and to teach the patient and his family